Impact of Body Mass Index on mortality in Swiss hospital patients with ST-elevation myocardial infarction: does an obesity paradox exist?
BACKGROUND: The obesity paradox refers to the phenomenon that obese patients seem to have a better outcome than normal weight patients in a variety of disease conditions. The aim of this study was to investigate the impact of Body Mass Index (BMI) on mortality in patients with ST-elevation myocard...
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| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2014-07-01
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| Series: | Swiss Medical Weekly |
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| Online Access: | https://www.smw.ch/index.php/smw/article/view/1892 |
| _version_ | 1797979511875174400 |
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| author | Fabienne Witassek Matthias Schwenkglenks Paul Erne Dragana Radovanovic |
| author_facet | Fabienne Witassek Matthias Schwenkglenks Paul Erne Dragana Radovanovic |
| author_sort | Fabienne Witassek |
| collection | DOAJ |
| description |
BACKGROUND: The obesity paradox refers to the phenomenon that obese patients seem to have a better outcome than normal weight patients in a variety of disease conditions. The aim of this study was to investigate the impact of Body Mass Index (BMI) on mortality in patients with ST-elevation myocardial infarction (STEMI) who underwent percutaneous coronary intervention (PCI).
METHODS: Between January 2005 and July 2012, the Swiss AMIS Plus registry enrolled 6,938 patients with acute STEMI who underwent PCI. These patients were stratified into 5 BMI groups according to the classification system of the World Health Organisation. The odds for in-hospital mortality according to BMI groups were analysed using logistic regression with normal weight patients as the reference.
RESULTS: Crude in-hospital mortality rates showed a U-shaped distribution between BMI groups, with the lowest mortality in obese class I patients (2.0%) and the highest mortality in underweight patients (9.0%). The odds for in-hospital mortality were significantly lower for obese class I (OR 0.56; 95% CI 0.35–0.91) and significantly higher for underweight patients (OR 2.72; 95% CI 1.14–6.48) compared to the normal weight group and odds ratios showed a U-shaped distribution. After adjustment for covariates, the odds ratios maintained a U-shape distribution albeit the differences between BMI groups were no longer significant.
CONCLUSION: This study showed that the lower crude in-hospital mortality of obese class I patients can be partly explained by lower age and lower co-morbidity rates. However, further studies are needed to investigate favourable factors associated with class I obesity.
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| first_indexed | 2024-04-11T05:40:58Z |
| format | Article |
| id | doaj.art-3de63058586e4859a1662e6aac99b852 |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2024-04-11T05:40:58Z |
| publishDate | 2014-07-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-3de63058586e4859a1662e6aac99b8522022-12-22T04:42:32ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972014-07-01144313210.4414/smw.2014.13986Impact of Body Mass Index on mortality in Swiss hospital patients with ST-elevation myocardial infarction: does an obesity paradox exist?Fabienne WitassekMatthias SchwenkglenksPaul ErneDragana Radovanovic BACKGROUND: The obesity paradox refers to the phenomenon that obese patients seem to have a better outcome than normal weight patients in a variety of disease conditions. The aim of this study was to investigate the impact of Body Mass Index (BMI) on mortality in patients with ST-elevation myocardial infarction (STEMI) who underwent percutaneous coronary intervention (PCI). METHODS: Between January 2005 and July 2012, the Swiss AMIS Plus registry enrolled 6,938 patients with acute STEMI who underwent PCI. These patients were stratified into 5 BMI groups according to the classification system of the World Health Organisation. The odds for in-hospital mortality according to BMI groups were analysed using logistic regression with normal weight patients as the reference. RESULTS: Crude in-hospital mortality rates showed a U-shaped distribution between BMI groups, with the lowest mortality in obese class I patients (2.0%) and the highest mortality in underweight patients (9.0%). The odds for in-hospital mortality were significantly lower for obese class I (OR 0.56; 95% CI 0.35–0.91) and significantly higher for underweight patients (OR 2.72; 95% CI 1.14–6.48) compared to the normal weight group and odds ratios showed a U-shaped distribution. After adjustment for covariates, the odds ratios maintained a U-shape distribution albeit the differences between BMI groups were no longer significant. CONCLUSION: This study showed that the lower crude in-hospital mortality of obese class I patients can be partly explained by lower age and lower co-morbidity rates. However, further studies are needed to investigate favourable factors associated with class I obesity. https://www.smw.ch/index.php/smw/article/view/1892myocardial infarctionpercutaneous coronary interventionobesity paradox |
| spellingShingle | Fabienne Witassek Matthias Schwenkglenks Paul Erne Dragana Radovanovic Impact of Body Mass Index on mortality in Swiss hospital patients with ST-elevation myocardial infarction: does an obesity paradox exist? Swiss Medical Weekly myocardial infarction percutaneous coronary intervention obesity paradox |
| title | Impact of Body Mass Index on mortality in Swiss hospital patients with ST-elevation myocardial infarction: does an obesity paradox exist? |
| title_full | Impact of Body Mass Index on mortality in Swiss hospital patients with ST-elevation myocardial infarction: does an obesity paradox exist? |
| title_fullStr | Impact of Body Mass Index on mortality in Swiss hospital patients with ST-elevation myocardial infarction: does an obesity paradox exist? |
| title_full_unstemmed | Impact of Body Mass Index on mortality in Swiss hospital patients with ST-elevation myocardial infarction: does an obesity paradox exist? |
| title_short | Impact of Body Mass Index on mortality in Swiss hospital patients with ST-elevation myocardial infarction: does an obesity paradox exist? |
| title_sort | impact of body mass index on mortality in swiss hospital patients with st elevation myocardial infarction does an obesity paradox exist |
| topic | myocardial infarction percutaneous coronary intervention obesity paradox |
| url | https://www.smw.ch/index.php/smw/article/view/1892 |
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